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Ineffective Oxygen Delivery

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1. Ineffective Oxygen Delivery

Ineffective Oxygen Delivery Ineffective Oxygen Delivery Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Ineffective Oxygen Delivery (...) Ineffective Oxygen Delivery Aka: Ineffective Oxygen Delivery , Nasal Catheter , Oxygen Tent II. Devices: Nasal Catheter (Avoid) Flexible lubricated oxygen catheter Holes in distal 2cm Advanced through nostril into pharynx behind uvula Risk of to adenoids and secondary Gastric distention or rupture if cannulate esophagus No advantage when compared with III. Devices: Oxygen Tent (Avoid) Clear Plastic shell encloses upper body Cannot reliably provide stable Oxygen Concentrations Although theoretically 50

2018 FP Notebook

2. Ineffective Oxygen Delivery

Ineffective Oxygen Delivery Ineffective Oxygen Delivery Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Ineffective Oxygen Delivery (...) Ineffective Oxygen Delivery Aka: Ineffective Oxygen Delivery , Nasal Catheter , Oxygen Tent II. Devices: Nasal Catheter (Avoid) Flexible lubricated oxygen catheter Holes in distal 2cm Advanced through nostril into pharynx behind uvula Risk of to adenoids and secondary Gastric distention or rupture if cannulate esophagus No advantage when compared with III. Devices: Oxygen Tent (Avoid) Clear Plastic shell encloses upper body Cannot reliably provide stable Oxygen Concentrations Although theoretically 50

2015 FP Notebook

3. CRACKCast E180 – Labor & Delivery

walk through the steps of a normal, spontaneous vertex delivery. Really there are three phases: head, then shoulders, then body and legs! Call for help Prepare your supplies A radiant warmer should be available and heated. Neonatal resuscitation adjuncts should be available, including a towel, scissors, umbilical clamps, bulb suction, airway equipment (oxygen, bag-mask device with appropriate sized masks, and tools for endotracheal intubation), and equipment to achieve vascular access. Don PPE (...) CRACKCast E180 – Labor & Delivery CRACKCast E180 - Labor & Delivery - CanadiEM CRACKCast E180 – Labor & Delivery In by Adam Thomas May 24, 2018 This episode of CRACKCast covers Rosen’s Chapter 181, Labor and Delivery. This chapter covers the high risk realm of ED deliveries, including potential complications such as PROM, malpresentation and umbilical cord emergencies. Shownotes – Key Points All ED deliveries should be considered high risk . Antepartum hemorrhage, PROM, eclampsia, premature

2018 CandiEM

4. Oxygen therapy administration in a non-emergency situation

mask Comes in three sizes: 250mls, 500mls and 1,500mls. The smallest one is ineffective even at birth. Two smallest bags have a pressure limiting valve set at 4.41kPa (45cm H 2 0) to protect the lungs from barotrauma (damage caused to tissues by a change in pressure inside and outside the body). The reservoir bag enables the delivery of oxygen concentrations up to 98 per cent. Without the reservoir bag it is not possible to supply more than 50 per cent oxygen ( ). Selection of most appropriate (...) related disorders palliative care for symptom relief ( ) Inform child and family Age appropriate information must be given to the child. Family members must be adequately informed ( ). Include the following information: need for oxygen therapy rationale and explanation for method of delivery positive/expected benefits of treatment possible side effects of treatment minimum duration of treatment Baseline assessment Wherever possible, a set of baseline observations should always be obtained

2014 Great Ormond Street Hospital

5. Shivering prevention and treatment during cesarean delivery under neuraxial anesthesia: a systematic review. (PubMed)

Shivering prevention and treatment during cesarean delivery under neuraxial anesthesia: a systematic review. Perioperative shivering during cesarean sections (CSs) under neuraxial anesthesia (NA) is clinically common but often under-treated. It may prominently increase oxygen consumption, which can be catastrophic for parturients with ischemic cardiovascular disease. Thus, the prevention and treatment of shivering may be of great significance in parturients. The purpose of this systematic (...) . Intrathecal fentanyl, intrathecal sufentanil, intrathecal meperidine, intravenous ketamine and intravenous tramadol were beneficial for reducing shivering during CSs under NA. MgSO4 administered intrathecally resulted in transient alleviation of shivering, and the effect did not persist. Two trials investigated the antishivering effect of intravenous ondansetron. The medication appeared to be effective in one trial, but ineffective in the other.Appropriate use of dexmedetomidine, fentanyl, sufentanil

2018 Minerva anestesiologica

6. Insights on Localized and Systemic Delivery of Redox-Based Therapeutics (PubMed)

Insights on Localized and Systemic Delivery of Redox-Based Therapeutics Reactive oxygen and nitrogen species are indispensable in cellular physiology and signaling. Overproduction of these reactive species or failure to maintain their levels within the physiological range results in cellular redox dysfunction, often termed cellular oxidative stress. Redox dysfunction in turn is at the molecular basis of disease etiology and progression. Accordingly, antioxidant intervention to restore redox (...) homeostasis has been pursued as a therapeutic strategy for cardiovascular disease, cancer, and neurodegenerative disorders among many others. Despite preliminary success in cellular and animal models, redox-based interventions have virtually been ineffective in clinical trials. We propose the fundamental reason for their failure is a flawed delivery approach. Namely, systemic delivery for a geographically local disease limits the effectiveness of the antioxidant. We take a critical look at the literature

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2018 Oxidative medicine and cellular longevity

7. Endolysosomal targeting of a clinical chlorin photosensitiser for light-triggered delivery of nano-sized medicines (PubMed)

of the entrapped agents that harnesses sub-lethal photodynamic therapy (PDT) using a photosensitiser that localises in endolysosomal membranes. Using light to trigger reactive oxygen species-mediated rupture of the photosensitised endolysosomal membranes, the spatio-temporal selectivity of PCI then enables cytosolic release of the agents at the selected time after administration so that they can reach their intracellular targets. However, conventional photosensitisers used clinically for PDT are ineffective (...) Endolysosomal targeting of a clinical chlorin photosensitiser for light-triggered delivery of nano-sized medicines A major problem with many promising nano-sized biotherapeutics including macromolecules is that owing to their size they are subject to cellular uptake via endocytosis, and become entrapped and then degraded within endolysosomes, which can significantly impair their therapeutic efficacy. Photochemical internalisation (PCI) is a technique for inducing cytosolic release

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2017 Scientific reports

8. Phenotypic correction of Fanconi anemia cells in the murine bone marrow after carrier cell mediated delivery of lentiviral vector (PubMed)

Phenotypic correction of Fanconi anemia cells in the murine bone marrow after carrier cell mediated delivery of lentiviral vector Fanconi anemia (FA) is an autosomal-recessive disorder associated with hematopoietic failure and it is a candidate for hematopoietic stem cell (HSC)-directed gene therapy. However, the characteristically reduced HSC numbers found in FA patients, their ineffective mobilization from the marrow, and re-oxygenation damage during ex vivo manipulation have precluded (...) clinical success using conventional in vitro approaches. We previously demonstrated that lentiviral vector (LV) particles reversibly attach to the cell surface where they gain protection from serum complement neutralization. We reasoned that cellular delivery of LV to the bone marrow niche could avoid detrimental losses during FA HSC mobilization and in vitro modification. Here, we demonstrate that a VSV-G pseudotyped lentivector, carrying the FANCC transgene, can be transmitted from carrier

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2016 Stem cell research & therapy

9. Intranasal Naloxone for acute opiate overdose: Reducing needle stick risk, improving time to medication delivery

modality for opioid overdose.[44] [It is not clear why this is reportable or why they make this conclusion. IV naloxone is also ineffective after the first dose 10-15% of the time due to the quantity of opioid consumed. As is very clear in all the provided references on this web page - there is NO 100% reliable single dose delivery method for naloxone. The providers must also support ventilation and if naloxone fails after one dose (given adequate time to be effective) they need to consider redosing (...) Intranasal Naloxone for acute opiate overdose: Reducing needle stick risk, improving time to medication delivery Intranasal naloxone to treat heroin and other opiate overdoses Therapeutic Intranasal Drug Delivery Needleless treatment options for medical problems (Scroll down if the text is missing on your screen) Concepts: Clinical-Uses: Education: Intranasal Naloxone for acute opiate overdose: Reducing needle stick risk, improving time to medication delivery Table of Contents: Literature

2010 Therapeutic Intranasal Drug Delivery

10. British guideline on the management of asthma

Regular preventer therapy 63 7.3 Initial add-on therapy 70 7.4 Additional controller therapies 72 7.5 Specialist therapies 73 7.6 Deceasing treatment 82 7.7 Specific management issues 82 8 Inhaler devices 85 8.1 Technique and training 85 8.2 ß 2 agonist delivery 85 8.3 Inhaled corticosteroids for stable asthma 86 8.4 Prescribing devices 86 8.5 Use and care of spacers 87 8.6 Environmental impact of metered-dose inhalers 87 9 Management of acute asthma 89 9.1 Lessons from asthma deaths and near-fatal (...) in adolescents 117 11.1 Definitions 117 11.2 Prevalence of asthma in adolescents 117 11.3 Diagnosis and assessment 117 11.4 Risk factors 118 11.5 Comorbidities and modifiable behaviours 119 11.6 Asthma attacks and the risk of hospital admission 120 11.7 Long-term outlook and entry into the workplace 120 11.8 Non-pharmacological management 120 11.9 Pharmacological management 121 11.10 Inhaler devices 121 11.11 Organisation and delivery of care 122 11.12 Patient education and self management 12312 Asthma

2019 SIGN

11. Improving outdoor air quality and health: review of interventions

Improving outdoor air quality and health: review of interventions Review of interventions to improve outdoor air quality and public health Review of interventions to improve outdoor air quality and public health 2 About Public Health England Public Health England exists to protect and improve the nation’s health and wellbeing, and reduce health inequalities. We do this through world-leading science, knowledge and intelligence, advocacy, partnerships and the delivery of specialist public health (...) services. We are an executive agency of the Department of Health and Social Care, and a distinct delivery organisation with operational autonomy. We provide government, local government, the NHS, Parliament, industry and the public with evidence-based professional, scientific and delivery expertise and support. Public Health England Wellington House 133-155 Waterloo Road London SE1 8UG Tel: 020 7654 8000 www.gov.uk/phe Twitter: @PHE_uk Facebook: www.facebook.com/PublicHealthEngland Prepared by: Naima

2019 Public Health England

12. Diagnosis and Management of Acute Pulmonary Embolism

Integration of aggravating conditions and comorbidity into risk assessment of acute pulmonary embolism 20 5.6 Prognostic assessment strategy 20 6 Treatment in the acute phase 22 6.1 Haemodynamic and respiratory support 22 6.1.1 Oxygen therapy and ventilation 22 6.1.2 Pharmacological treatment of acute right ventricular failure 22 6.1.3 Mechanical circulatory support and oxygenation 23 6.1.4 Advanced life support in cardiac arrest 23 6.2 Initial anticoagulation 23 6.2.1 Parenteral anticoagulation 23 6.2.2 (...) CYP3A4 Cytochrome 3A4 DAMOVES D-dimer, Age, Mutation, Obesity, Varicose veins, Eight [coagulation factor VIII], Sex DASH D-dimer, Age, Sex, Hormonal therapy DVT Deep vein thrombosis ECMO Extracorporeal membrane oxygenation ELISA Enzyme-linked immunosorbent assay EMA European Medicines Agency ERS European Respiratory Society ESC European Society of Cardiology FAST H-FABP, Syncope, Tachycardia (prognostic score) FDA US Food and Drug Administration GUSTO Global Utilization of Streptokinase and Tissue

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2019 European Society of Cardiology

13. Diagnosis and management of epilepsy in adults

of and monitoring treatment effects in patients with status epilepticus. EEG should be available as an emergency intervention for all patients with treated or suspected status epilepticus. 2.3 MANAGEMENT OF PROLONGED SEIZURES INCLUDING STATUS EPILEPTICUS ? As soon as possible: y secure airway y give oxygen y assess cardiac and respiratory function y secure IV access in large veins. B Patients with prolonged tonic-clonic seizures that have lasted five minutes or more should be given: y midazolam 10 mg buccally (...) an antiepileptic drug that does not induce hepatic enzymes. Women with epilepsy should: B y receive prepregnancy counselling at the time of diagnosis and at regular intervals during their management, especially if they are taking antiepileptic drug treatment D y be reassured that most will have a normal pregnancy and delivery C y have their diagnosis and treatment, if appropriate, reviewed by specialist services before conception; a concerted effort should be made to optimise seizure control and rationalise

2018 SIGN

14. Motor neurone disease: assessment and management

techniques such as manual assisted cough to people with MND who cannot cough effectively. [new 2016] [new 2016] 1.13.2 Consider unassisted breath stacking and/or manual assisted cough as the first-line treatment for people with MND who have an ineffective cough. [new [new 2016] 2016] 1.13.3 For people with bulbar dysfunction, or whose cough is ineffective with unassisted breath stacking, consider assisted breath stacking (for example, using a lung volume recruitment bag). [new 2016] [new 2016] 1.13.4 (...) respiratory function: oxygen saturation measured by pulse oximetry (SpO 2 ): this should be a single measurement of SpO 2 with the person at rest and breathing room air if it is not possible to perform pulse oximetry locally, refer the person to a respiratory ventilation service. Then one or both of the following: forced vital capacity (FVC) or vital capacity (VC) [3] sniff nasal inspiratory pressure (SNIP) and/or maximal inspiratory pressure (MIP). [2010] [2010] 1.14.9 If the person has severe bulbar

2016 National Institute for Health and Clinical Excellence - Clinical Guidelines

15. Guidelines on Diagnosis and Management of Syncope

: medication causing low BP (due to vasodilatation or hypovolaemia), alcohol use, volume depletion (haemorrhage, low fluid intake, diarrhoea, vomiting), pulmonary diseases causing reduction in brain oxygen supply, environmental factors (thermal stress). There are two main pathophysiological mechanisms in reflex syncope. “Vasodepression” refers to conditions in which insufficient sympathetic vasoconstriction results in hypotension. , “Cardioinhibition” is used when bradycardia or asystole predominates (...) , diarrhoea, vomiting), pulmonary diseases causing reduction in brain oxygen supply, environmental factors (thermal stress). There are two main pathophysiological mechanisms in reflex syncope. “Vasodepression” refers to conditions in which insufficient sympathetic vasoconstriction results in hypotension. , “Cardioinhibition” is used when bradycardia or asystole predominates, reflecting a shift towards parasympathetic predominance. The haemodynamic pattern, i.e. cardioinhibitory, vasodepressive, or both

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2018 European Society of Cardiology

16. Review of effective strategies to promote breastfeeding

INSTITUTE as political will, legislation and policy, and funding and resources. 11 Also identified as crucial elements are effective advocacy (including social mobilisation); improving quality coverage of training and program delivery; national breastfeeding promotion and public awareness programs; and research, evaluation and monitoring systems. This Evidence Check examined the relevant literature between 2007 and 2017, using several search strategies and systematic screening strategies, focusing (...) in breastfeeding. Tsai 227 investigated the change in, and correlates of, breastfeeding practices in Taiwan after delivery at a hospital and at one, three, and six months postpartum among first-time mothers. Early initiation of breastfeeding, rooming-in practice and self-efficacy were significantly related to exclusive breastfeeding during the hospital stay. After discharge, health literacy, knowledge, intention and self-efficacy were positively and significantly associated with breastfeeding exclusivity

2018 Sax Institute Evidence Check

18. AIM Clinical Appropriateness Guidelines for Sleep Disorder Management

Guidelines are also available upon oral or written request. Although the Guidelines are publicly-available, AIM considers the Guidelines to be important, proprietary information of AIM, which cannot be sold, assigned, leased, licensed, reproduced or distributed without the written consent of AIM. AIM applies objective and evidence-based criteria and takes individual circumstances and the local delivery system into account when determining the medical appropriateness of health care services. The AIM (...) positive airway pressure therapy or bi-level ventilation, attended by a technologist 95800 Sleep study, unattended simultaneous recording heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time 95801 Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation and respiratory analysis (e.g., by airflow or peripheral arterial tone) 95806 Sleep study, unattended, simultaneous recording of heart rate, oxygen saturation

2019 AIM Specialty Health

19. Peri-operative care of people with dementia

(including those with dementia) are moresensitivetothehypnoticandcardiovasculareffectsof anaesthesia, and so merit close intra-operative monitoring of depth of anaesthesia and cardiovascular physiology [1]. Comorbidities and polypharmacy can increase the likelihood of critical organ ischaemia during anaesthesia, but anaesthetists can counter the adverse pharmacodynamic effects of anaesthesia on oxygen delivery by monitoring simple physiological parameters in allolderpatients(non (...) recommend continuing donepezil and ©2019AssociationofAnaesthetists 5 Whiteet al. | Peri-operativecareofpeoplewithdementia Anaesthesia2019managing muscle relaxation accordingly, using neuromuscularmonitoring(ideallyacceleromyography). Galantamineandrivastigminehaveshorthalf-livesand canbediscontinuedthedaybeforesurgery. After emergency surgery involving neuromuscular blockade, neostigmine may be ineffective or prolong neuromuscular blockade. Short-acting neuromuscular blocking agents

2019 Association of Anaesthetists of GB and Ireland

20. Handbook on tuberculosis laboratory diagnostic methods in the European Union

are not mutually exclusive and both bring advanced diagnostics closer to the patient. The handbook is designed to meet the needs of both centralised and decentralised service delivery models and recognises that the role of national reference laboratories will change significantly over the next few years. How this handbook relates to other work available in this field This handbook presents a compilation of methods currently applied in EU/EEA Member States. It describes common work carried out and endorsed

2018 European Centre for Disease Prevention and Control - Technical Guidance

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